What is a Bunion (and What Can You Do About It)?
When we’re asking what a bunion is, we are not assuming you don’t know one when you see it.
Bunions have very good branding, after all. A tell-tale bump at the base of the big toe is hard to miss, especially if you have had it for some time and it has grown progressively more pronounced over the years.
Most people know what a bunion is, but not as many fully understand what the underlying cause of that bony bump is, and—even more importantly—how to best address that. There is often much that can be done to help a patient with a bunion, and quite frequently there is a lot we can accomplish even without surgery!
The Fundamentals of Bunions
It is easy to focus purely on the “bump” of a bunion, but the source of the problem deals involves the entire metatarsophalangeal (MTP) joint at this spot. This is the large joint located at the base of your big toe.
Normally, this joint is perfectly stable and performs its duties without a hitch. However, an instability in the joint can lead to the entire big toe shifting toward its neighboring toes over time. As it does so, the MTP joint begins to stick out to the side and develop more of a bump.
The instability that causes bunions is believed to largely be hereditary in nature. In other words, bunions tend to run in families. If there are many cases in your family tree, odds are relatively high that there is an inheritable abnormality within the structure of your foot. You might have flat feet, low arches, or even looseness in the tendons, ligaments, and other soft tissues that surround your joints.
Other factors can certainly contribute to one’s bunion risks, however. These can include:
- Repetitive stress on the feet and toes. This can come from jobs that require lots of standing and walking, as well as activities such as dance and running.
- Pregnancy. Hormonal shifts while carrying a child can cause joints to loosen and lose stability. Combine that with the extra weight of pregnancy and bunion risks can increase.
- Conditions that can cause damage to joints. Forms of arthritis including gout and rheumatoid arthritis can be counted among these, as can past trauma to the MTP joint.
- Stress-causing footwear. There is some debate over whether shoes with tight, narrow toe boxes and/or high heels actually cause bunions, but it is indisputable that they can make existing bunions worse. If a bunion is just starting to develop, shoes that place excess pressure against the toes and the front of the foot will accelerate it.
Whatever the underlying causes of your bunion may be, properly identifying them is the first step toward effectively addressing the situation. Not every case is treated the same way, even if the primary goals remain similar.
How We Approach Bunion Treatment
Many people tend not to do all they could to address their bunions, or even anything at all. Some believe that the only form of treatment that would have any real effect is bunion surgery, and they do not want to consider such measures.
The truth, however, is that surgery is often not the first consideration when treating a bunion. Treatment is much more than simply “making the bump go away.” Our primary goals are:
- Relieving the pain, discomfort, and other symptoms caused by a bunion.
- Slowing or preventing further progression of the deformity.
If we can achieve these goals using non-surgical methods, we will recommend them in almost every case—even if that means the bunion itself still exists.
Why this approach? Because surgery is a major step, only to be used when other forms of treatment do not provide the level of relief that is needed. It is also true that, in some cases, surgery to “repair” a bunion will not take care of the underlying instabilities that caused it in the first place. There is a risk that the bunion will begin to develop again, so age and other factors must be considered for surgery as well.
Conservative measures we might employ for bunion treatment include:
- Changes in footwear, to better accommodate and reduce stress on a bunion.
- Stretches and exercises to help relieve pain and increase mobility in the joint.
- Pads, splints, and other protective items to reduce friction between your toes and against the insides of your shoes.
- Warm soaks, ice packs, medication, cortisone injections, MLS laser therapy and other options that can help reduce pain and inflammation.
- Prescribing custom orthotics to help take excess pressure off of problem areas; especially helpful if an inherited abnormality in foot structure is a factor.
If bunion surgery is a necessity, we will be sure to fully discuss what would be expected from the procedure itself, how to prepare for it, and what you should expect from the recovery process.
There is a wide variety of different types of bunion surgery. Some involve cutting or reshaping the bones. Others involve repairing tendons and other soft tissues around the joint. The entire joint might also be fused in some cases to provide for better pain relief.
One particular form of surgery that we often employ for moderate to severe bunions is a Lapidus bunionectomy.
In this procedure, the prominence of the bump is removed, and a tight tendon that can pull the big toe outward is released, if needed. The 1st metatarsal and the bone beneath it (which are often too flexible in a bunion) are then fixed together with a plate and screws to hold it steady. The surgical hardware is attached permanently, unless a need to remove it presents itself.
The specific type of bunion surgery recommended will depend on several circumstances surrounding each case. We will fully discuss all options and possibilities with you before any decisions are made to move forward.
Don’t Wait for a Bunion to Get Bad (Or Worse)!
It should only be sensible that a bunion identified in its earlier stages will be open to more effective treatment options. However, even a bunion that has been a constant companion for decades may still greatly benefit from conservative treatments!
The key lies in not putting off expert bunion treatment any longer. Take the first step and schedule an appointment at any of Foot & Ankle Clinics of Arizona’s eight area locations. You can call us at (480) 817-2300 or request an appointment online using our scheduler.
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Dr Leber, native to Arizona, believes the quality patient care involves clear communication while offering consistent and research-based treatment that includes exhaustive conservative care and surgical options when necessary.
- Bachelor of Science in Exercise Science – Brigham Young University, Utah
- Doctor of Podiatric Medicine- Western University of Health Science, CA
- Medical missions to Guatemala and Nicaragua
- Podiatric Medical and Surgical Residency- VA
- Health System-Albuquerque NM
- Chief Resident Kaiser Permanente Sacramento CA
- Chandler Regional Medical Center
- Arizona Specialty Hospital
- Banner Desert Medical Center
- Tempe St Lukes
Extensive training in trauma, rear foot and ankle reconstruction, arthroscopic techniques, biomechanical and structural deformities, congenital deformities and diabetic care.
- Spending time with his wife and 5 children
- Playing Guitar
- English (Native)
- Spanish (fluent)